About the Role
This role is responsible for vendor management, performance measurement, and analytics for Enterprise Risk Adjustment. Drives strategy, ensures accurate KPI reporting, and partners cross-functionally to optimize vendor and operational performance across Commercial, Medicare, and Medicaid programs.
What You'll Do
Job Responsibilities:
- Develop and lead risk adjustment vendor strategy aligned to enterprise goals
- Identify vendor needs, source and evaluate partners, and define success measures
- Negotiate contracts and own day-to-day vendor relationships
- Lead RFPs, vendor selection, implementation, and offboarding
- Manage onboarding and wind-down activities including data retention and destruction
- Ensure effective transition and integration of vendor services
- Design and maintain KPI frameworks for vendors and internal operations
- Develop models and reporting to measure financial impact and operational outcomes
- Analyze performance trends and identify improvement opportunities
- Audit internal and vendor reporting for accuracy and completeness
- Ensure data integrity and adherence to measurement standards
- Support compliance and internal control requirements
- Monitor vendor spend, billing, and budget performance
- Develop forecasts and provide financial insights to leadership
- Advise on budget risks and mitigation strategies
- Review and reconcile vendor invoices to ensure accurate and timely payment
- Partner with enterprise leaders to define targets and corrective actions
- Present insights and recommendations to executive stakeholders
- Mentor and guide analytics and reporting teams
What You Bring
Education/Experience:
- Bachelors degree preferred in business, finance, statistics, healthcare, or related field.
- 6+ years healthcare or insurance experience with analytics/reporting.
- 3+ years supervisory experience.
Knowledge:- Extensive knowledge of risk adjustment and vendor performance management.
- Strong analytical and statistical modeling skills.
- Experience developing KPIs and performance frameworks.
- Advanced Excel proficiency.
- CPA or CMA certification preferred.
- Experience with SAS, R, or SQL preferred.
- Experience in ACA, Medicare, or Medicaid risk adjustment programs preferred.
Skills and Abilities:- Vendor Management
- Risk Adjustment Analytics
- KPI Development
- Financial Modeling
- Contract Negotiation
- Data Analytics
- Stakeholder Management
- Regulatory Awareness
Salary Range:
$109,600 - $149,625
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
